New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 40A - '40 STATES' FILE AND USE STANDARDS AND PROCEDURES
Section 11:4-40A.3 - Eligibility

Universal Citation: NJ Admin Code 11:4-40A.3

Current through Register Vol. 56, No. 18, September 16, 2024

(a) Forms submitted to the Commissioner on the basis that they have been made available for sale or use in 40 states, subject to state variations that do not alter the unique features or design of the product, shall be eligible for sale or use pursuant to the requirements of this subchapter. Notwithstanding eligibility, any such form shall comply with New Jersey law regarding standard contract provisions as identified below.

1. Individual Life:
i. Free Look as set forth in 17B:25-2.1;

ii. Grace Period as set forth in 17B:25-3;

iii. Incontestability as set forth in 17B:25-4, 16 and 17;

iv. Entire Contract as set forth in 17B:25-5;

v. Misstatement of Age as set forth in 17B:25-6;

vi. Dividends as set forth in 17B:25-7;

vii. Policy Loan as set forth in 17B:25-8;

viii. Reinstatement as set forth in 17B:25-9;

ix. Payment of Premium as set forth in 17B:25-10;

x. Automatic Premium Loan Notice as set forth in 17B:25-10.1;

xi. Payment of Claims as set forth in 17B:25-11;

xii. Beneficiary as set forth in 17B:25-12;

xiii. Nonforfeiture Benefits as set forth in 17B:25-19(a) and (l);

xiv. Title as set forth in 17B:25-14; and

xv. Period in Which to Commence Cause of Action as set forth in 17B:25-15;

2. Group Life:
i. Requirements for Eligible Groups as set forth in 17B:27-1;

ii. Dependents as set forth in 17B:27-9;

iii. Grace Period as set forth in 17B:27-11;

iv. Incontestability as set forth in 17B:27-12;

v. Application, Representations not Warranties, Entire Contract as set forth in 17B:27-13;

vi. Evidence of Insurability as set forth in 17B:27-14;

vii. Age Adjustments as set forth in 17B:27-15;

viii. Participating Policies as set forth in 17B:27-16;

ix. Beneficiary and Facility of Payment as set forth in 17B:27-17;

x. Certificates as set forth in 17B:27-18;

xi. Conversion as set forth in 17B:27-19 and 20;

xii. Death within Conversion Period as set forth in 17B:27-21;

xiii. Certificate to Debtors as set forth in 17B:27-22; and

xiv. Conversion of Debtors as set forth in 17B:27-23;

3. Individual Annuity:
i. Standard Nonforfeiture Law as set forth in 17B:25-20(f), (l), (o) and (p);

ii. Misstatement of Age or Sex as set forth in 11:4-43.3(c)4; and

iii. Premium payments as set forth in 11:4-43.5(a); and

4. Variable Contracts:
i. Required statements as set forth in 17B:28-4; and

ii. Form of contract as set forth in 17B:28-5(c) and (d), except that a periodic report that complies with N.J.A.C. 11:4-45 shall be considered to be approved by the Commissioner as required by 17B:28-5(c)(iii).

(b) Carriers shall solicit, market, administer and service forms made available for sale or use pursuant to P.L. 2001, c. 237 in accordance with all applicable New Jersey statutes and rules, including as of April 7, 2003:

1. Advertisement of life insurance and annuity, N.J.A.C. 11:2-23;

2. Accelerated death benefit, N.J.A.C. 11:4-30;

3. Fraud warning statement, N.J.S.A. 17:33A-6c;

4. Funeral insurance policy, N.J.A.C. 11:4-25;

5. Group coverage discontinuance and replacement, N.J.A.C. 11:2-13;

6. Illustrations, N.J.A.C. 11:4-52 and 17B:28-5(b);

7. Juvenile insureds, 11:4-24.4;

8. Life Insurance Solicitation, N.J.A.C. 11:4-11;

9. Life and Health Insurance Policy Language Simplification Act, 17B:17-17 et seq.;

10. Limited Death Benefit Form, N.J.A.C. 11:4-21;

11. Loan notices, 11:4-41.3(b)7;

12. New Jersey Fair Credit Reporting Act, 56:11-33;

13. Periodic reports, N.J.A.C. 11:4-45;

14. Replacement of life insurance policy, N.J.A.C. 11:4-2;

15. Standards for smoker/nonsmoker and/or tobacco/nontobacco reclassification, 11:4-41.1 4;

16. Trade practices and discrimination, 17B:30-1 et seq.; and

17. Unfair claims settlement practices, N.J.A.C. 11:2-17.

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